Method and apparatus for x-ray work



5 Sheets-Sheet 1 sept.' 2o, 1927.

M.l B. ADRIAN METHOD AND AEPARATUS FOR X-RAY WORK Filed June 16, 1921-HGLJ Se t. l 19 p 20 27 M. B. ADRIAN METHOD JAN) APPARATUS FOR X-RAYWORK 5 Sheets-Sheet 2 flviled June le, 1921 i @al arromers.

Sept. 20; 1927.

1 1,642,915 M. B. ADRIAN METHOD AND APPARATUS' Fon x-RAY worm Filed June1e, 1921 5 Sheetsshet 5 Se t.

.P 2.0 1.927 M. B. ADRIAN METHOD AND APPARATUS FOR X-RAY WOK Filed Junele; 1921 5 sheefs'sheet 4 l INVENTog. M EY' Y 1,642,915 'sept' 20, A v lv M' B. ADRIAN 'METHOD AND APPARATUS FOR x-RAY woRK Filed June 16, 19215 Sheds-Sheet 5 qc i,

P16211'V I to providea machine in Patented Sept. 20, 17927.

MATTHEW B. ADRIAN, or yiviimvAnxnn, Wisconsin, A'ssrGNoRToiTHr-i ADRIANoon- PoRATIoiv, rive., or` MILWAUKEEYWISCONSIN, A

CORIEORATION O1?v WISCONSIN.

METHOD AND APPARATUSFOLR Xk-RAY WORK.

vApplication filedJnne 16, 1921i Serial No; 477,905.

. This invention relates to a method and apparatus for conducting Xerayexaminations.I and is particularly directed toa method for examining the`foot of a patient and to a mae chine for effecting such examination.

It is well known that Vinthe radiographic yexamination, of the lfeet ot.patients thaty the results osuch examinationsare usually un.-satisfactory as they merely examine the foot in its unloaded or freecondition. There has" been a long 'felt want for a machine `(by which itispossible to Aexamine the foot of a patient not only in the unloadedcondition or free from the weight oit the body, but also whilethe tootis active in sustaining its share of the weight of the body. It is alsokobvious f that it is imperative, or a properly conducted examination',to provide a machine for the above outlined purposes by which it ispossible to examine theoot Vfrom any: one Aof a great number of angles,that is to say, look throughthe foot directly downwardly and alsosidewise through the ootso asto examine the articulation ory associationof the bones of the toot whilethey arecsustaining the weight of thepatient...v It is :therefore a primary object ofthis inventionto providean X-ray ,machinel which will ulllfvthe above outlined requirements:4

-A Objects ot' this inventionl are to provide ain X-ray machineor-,examining-the foot of a patient either encased in orree of'slioes;

whichthe examination of vthe toot/is madevvhile such ,toot is .underlthe normal tresses iinposedthereon,

Jthat istosay, while the lfootfis supporting yits part of the weightofthe patient; to pro` k'vide a machine lin which ...the .examination maybe continuouslyl conducted while'lthe weight is shifted orvariedso.astoaccurately 1 ascertain the relative positioning ot y Ithebcnes and joints of the or unit'oiinvpressure; and togprovdefsuch amachine so arranged that both the rpatient Vand operatorniaysimultaneously examine the foot so that detects reelyffdiscussed duringthe examination. .n

x Further objects are to.,V provide anv Xray the'foot ota-fpatientmachine for' examining- H iii-whichy Provision is. madeOBzVle-Wmg' the .nbonesot the toot at several didereiitangles ',wvherebyis machine in which provision is made ifor rolployed to ex'ainiinetheootfo av patientv kany.

`mirrors vmachine` lfor examining ootlunderfvarying patients varyingheights; 'means whereby cupsmayfbe ma1ntained,` as for example,by

foot looking directly down thereon and also to examine Qthe arch ofthefoot by looking horiz ontally across the foot or through the f foot ineither direction; and to provide such Y al machine arranged to allowthis examination without necessitating changing the position of eitherthe` operator or ofi the paftient. f

Further obj ects` are to 4provide an LX.ray

machine for examining the Jfoot ot apatient :inl-which provision ismade-for pointing out and indicatingupon the fluorescent screen.thedefecta or. various points that itis desiredto call 'to theattentionof the patient;

'to provide such.api'nachine` arranged ltor eitheririuoroscopicinspection or for lthe production of permanent pilates; and to lprovidesucha machine so organized that unskilled operators may use it withoutdangerof any kind andwith absolute assurance of the resultsj:

Further objects areto provide` anX-ray tating the tubeso thatl onek tubeniay be enione 'not a plurality ot angles gto provide a 's eriessot'mirrors Vso arranged that they will cooperate lwitli the *tubeA inlyany one-of itsmany pqsitions and directthe visible rays vtoa;suitablelocation for both ythe pa-v tient andthe operator; and toprovide such afinachine ,so organiZedt-hat the cooperation oitheniirrors and :of theltube is assured and isv automatic j vwhile.still vvpermitting manual control ofeither the ltube oro the at theiwill'of the operator. Y

L'Further `objects are to provide an X-ray ,the Jfoot ofthe patient vinwhich eyejlpieces or eye cups are provided for lthey 'operator `and. forthe] patient,y and if desi'ied,forv an additionalobserver tolprovideImeans for adjusting the height of the' eye` pieces to accommodate andtoprovide a sanitary 'condition 'of eye providing removableV sanitary:`cups soV that atteruone use' thereof'the cups maythen beA .discardedanda new cupgrgd new Set Ofc-ups substituted. Y Y

th r objects iare .togv provide a method from "fieri examining"thefeetef a retient either while said toot is bare or while it isencased within a. shoe; to provide a method for conducting suchexamination while the toot is loaded, that is to say, bearing,l weight;and to provide a method tor examining the articulation olf the bones otthe feet while the weight of the body is thrown upon the balls ot thel'eet.

An embodiment ot' the invention is shown in the accompanying drawings,in which:

Fig. l is a side elevation ot the apparatus.

Fig. 2 is an end elevation thereof.

Fig. 8 is an end elevation ol the apparatus with the upper hood removed.

Fig. ll is a plan view oit' the structure shown in Fig.

Fig. 5 is a. side elevation ot' the structure shown in Fig. 3.

Fig. ti is a detail ot' the sanitary eye cup.

Fig. 7 is an end view of a further torni ot' the invention showingl aportion ot the cabinet removed to illustrate the interior construction.

Fig. 8 is a side elevation ot the device shown in Figi. 7.

Figure E) is a diagrammatic end view showing` the positions that themirrors, tube, and the particuhir screen then in use, occupy, and alsoshowing the path ot the X-rays and of the visible or light rays.

Fi gure l0 is a plan view of one of the mirrors detached.

Figure ll is a fragmentary view showing one ot the spring catches in theposition it occupies when it eo-operates with the supporting lever ot'the tube.

The device comprises a. boxlilte structure having; a permanent baseportion and a removable top or hood l. The base portion is composed otside members 2 and 3 and a pair ot'` top members et and 5 arranged atdifferentl levels as may be seen from Figs. l and 5 so as to providesteps for the oncoming patient. The top #i which is at the higher levelhas eut out portions adjacent its front, leaving a central tongue Gwhich extends to the front of the machine and is `secured thereto. Thistongue is the portion of the apparatus upon which the patient places histoot during the examination. i The X-ray tube is adjustably mounted sothat it may be positioned beneath `this panel or tongue G in a mannerhereinafter to be described.

The removable top or hood l is composed ot side members 7 which convergetowards theirupper portion and with a pair ot slanting rear members 8and a slantinpr liront member il. It is to be noted from an inspectionol Figs. l, et and 5 that the rear portion ot the hood has a cut outformation which is secured by an upright panel l() which extends 'fromthe rear upper edge ot the slanting; piece 1l to the plane ot themen'ibers S. It will further be noted that the slanting hood compels thepatient to lean forward while he inspects his feet., thereby placingweight di reetly upon the balls ot the feet and causingv the bones toassume the relative positions they normally occupy when sustaining theweight ot the body. lriangular side portionsl 'I2 join this uprightpanel and the rear portion -s S and complete this portion o-t' the hood.The top ot the hood is formed oll u slanlinp.` substantially recangulartop member l5- which is provided with openingsl ll and l5 adapted toreceive eye pieces. It desired, shutters may be resiliently and slidablymounted beneath the top portion l?) and may be pulled out when it isdesired to use either ot' the peep holes, such sluittera beine alaptedto close the unused peep holes and thereby keep the interior oitI thehood relatively darlt. The hood is provided with a rectangular bo.\:-like structure lli which opens into the hood and is open at its upperend. A sin'iilar slightly larger boxlilte member lT telescopes theportion lll. Suitable lduidingl rods 1S, extending' upwardly uponopposite sides trom the base portion and corre iponding telescopicmembers lO extendinp` downwardly 'from the upper portion and providedwith thumb nuts 20. are adapted to lock the adjustable members in thedesired position. The upper member 17 has a rectangular closed top 2l.which is provided with au eye piece Q2 through which the patientmaylook. The width ot the boxlilte lstructure is such that the patient mayloolt either downwardly or to opposite sides ot' the hood portion andsee the reflection in the particular mirror in use.

In order to provide proper ventilai'zion 'tor the appz'iratus, the baseportion is provided with openings 23 upon oppositesides. lfhese openingsconimunicate with a blackened box Ql which is provided with a series otblackened baille plates 2:3 adapted to allow circulation ot air butprevent the pase-rage of light therethrough.

The location of the generatina` apparatus and of the control apparatusn'iay conveniently be as follows. It direct current is turnished, aconverter 2G may conveniently be positioned beneath the floor portion 5.The main transformer Q". electrically connected thereto and supplyingthe tube with high tension current7 may be located beneath the lioorportion f1. A relatively small transformer 2S may be located adjacentthe main transformer and may supply the filament current oli theCoolidge tube. Upon the front of the apparatus. a` main switch arm Q9extends outwardly therefrom and controls the main or supply circuit torthe entire apparatus. A starting rheostat arm 3() extends through anarcuate slot 3l and controls the converter 2G. A rheostat knob 53:2controls the current supplied the filament ot the Coolidge tube and maybe provided with a pointer adapted to, indicateupon a suitablefscale 84the milliamperes flowing inthe filament circuit for the particularsetting of the rheostat.` y f One of the sanitary eye pieces previouslymentioned is illustrated insection in' Fig. 6.

It comprises abase portion 35 provided with suitable apertures 36whereby it may be secured adjacent theapliiropriatev opening. *Itis'providedwith a groove 37'into which vthe contracted portion of asanitary eye cup 38 is adapted to be slipped. 'It is understood j thatthese cups 38 `may Vbe discarded after one use and a new cupv readilyinserted withinthe slot.37. In thismanner, the patients have noVhesitancy in placing their faces in contact A; foot'switcli`39 maybeconnected by suitable flexible conductors 40, carried in' a cable, forinstance, with the primary circuit in the -main transformer 27 land-maythereby control the operation otthe X-rayytube., The

electrical connectionsof this machine are dis-y l rI his arm isadapt'edto be locked in any one of the Vthree main positions ,3 bylmeans or spring catclies and niay further bej locked in any intermediateposition by mea-nsot the set screw 46. A.These `c`atches45fm`ay-nbevseen y,noted that a plurality of these catches, which consist'otIafsp'ringpressed plunger andany operating external knob," f may :beprovided about the tace of the front portion of the machine. `It is-'.ob`vious thatf these" lcatches may' feo-operate with 'the V tube`v`supporting lever'42'for 47, (depending upon which modi- "lication isinuse), and may 'thereforevhold the? tube in. any one of severalpositions' ofk ."adjustment. It is alsotofbe iioteclfthatI `an-V othermanner of'loclring theftube-inlthese various positions of adjustmentymay be secured by means of the set screw46 which passes thru and isvthreaded"to a stationary portion of the machine andbears atits lowerend upon the shaiil`43 of tlie'operating crank 44 in an obviousandgwellffknown manner.y The outer portionf of fthe v*arm provided witha horizontal part 47 upon wlificha 4box 48V is mounted; Within fthisbor' A48 a pair of supports 49 yc'zarry the"lea1dfglarss casing 50Rvithin `wliicli`-^thetubef`41'is' mounted', the

with the cups'while the'examinationvis in. progress.

substituted for the fluorescent slides; examining. the footvwith Vthetube in the posilead glass `'casingfof course being provided Y `with acutout or open portion lto allow thefree passage' oftheX-'rays The box48l is providedwiththeventilators 52. and 53 similar to the ventilators`previously described but of small size. The box is preferably paintedwith lead paint throughout its -entire-portion'eXcept for a relativelysmall circular area directly over the opening 51 of the-lead glassshield 50. Spring reels 53 resilient-ly liold-the conductors 54 in tautcondition whileallowing motion of the tube with corresponding unreelingof the conductors; These conductors supply the filament `current andlalso connect one side of the high tension transformer 27. The otherconductor 55 which yconnects the other end of the -tube with thehightension.transformer circuit is resiliently heldtaut by means of thespring reel 56 locatediipon the floor ofrthe compartment Aandadjacentthe other end of `,the tube sofas '.tosecure adequate. spacing fortheiiigli tension leads.

Theinner walls 57 and158 of the bottom porti-on, which extends upwardly7a material distance ff'rcm the floor, portion 4,' are `provided withguide waysfwithin which slide in the floor portiony 4. These screens areadapted to car1y,:when desired, suitable plates-for radiographic work,or additional slidesy ior carrying suitable plates maylbe 4or tion-shown infFig. 5 a iluorescent screen is "removably carried by. thepanel 11. This fluorescent screenis, of course, suitably pro-'tcctedandis carried upon kthe'upper side of 'the fluorescentY screens59 `and 60,*such screens 'f being:v adapted to be withdrawn rearwardlyvandl sliding in the grooves 61 and 62 formed -,thepanel unless suchpanel is made V'of n'ia- Y ,terial*transparent to the* 'visible` rays.'Another way: of -mounting this ,fluorescent lscreenwouldbe tosubstitute it for: the panel all. andezallowfthe tscreen. to therebyreplace ,siichfpanelef lt is, of course, understood thattheseiuorescent#screens. are suitably protected and mounted 1 z A Zpair,ofv mirrors "63 and 64 are arranged l within the kbase portion` and-arehingedly mounted at .65 andf66 adjacent opposite fsid'es thereof@rlfhese*mirrors are normally supported at'about '45 by any -suitablemeans', iaslrforexample, adjusting screws .67

and 68,' and are 4provided upon their'under f surface'fwithcam members69 and 70,vre

ispectively, of insulating material. .,lVhen the -tube is rotatedbytheoperatingv crank144 into'y 'the right or .left-hand position, one'offwhiefl'i is indicatedV in ITig.V 2, its housing ,or

Ipartsx48 Contact with the corresponding cam member 69er 70 and kelevatethe correspondinc'fmirror ,asindijcated in Fig. 2'sotl`iatfthe lmirroris movedi'eut ot theway of the tube andi allowsl thetub'e to. bepositioned directly in line with the. toot of the patient and opjiosite`the other or active mirror. It any other angular adjustment of the tubeis desired, it may be secured by locking the shaft 43 by means ol theset screw tti and corresponding-ly adjusting the mirrors by theadjustinnh screws G7 and GS.

In order to indicate the various detects or points to the patient, auniversally mounted pointer 7l is provided and extends through the topportion 13 ot the hood or upper portion ot the cabinet. It is providedwith a handle 7&2 by which the operator may indicate upon the mirrors orupon the protecting,- member ot the central fluorescent screen thevarious points that he wishes to call the lraitientis attention to. Inthis manner, a very rapid examination may be made and the patient andoperator my discuss with certainty the various defects illustrated. Forexamjiile. any particular point may be indicated by the operator withoutnecessitating the removal of either the operators or patieuts face fromthe corresponding' eye cup.

Figs. 7 and 8 showing the .modified torni will now be described. Theconstruction. except as indicated, is substantiallyY similar to thatpreviously described. In this modified forni, the tube is housed withinthe protectingbox 73 which in turn is carried upon the pivotally mountedlever 74, such lever being,f operated from the crank shaft 7 5 in themanner previously described. This lever 74e has, homwer, au extendedportion 7G upon the opposite side of the crank shaft 75 from thatoccupied by the portion 74. This extension 7b' carries a fluorescentscreen and protecting member or plate holder.l either or both of whichmay be removably mount,- ed. This fluorescent screen and protectingsheath is indicated at 77. It will be seen that as the tube is rotatedabout the crank sha-tt 75 that the screen will correspondingly rotate.This construction maintains the screen and tube upon opposite sides ofthe object to beexamined at all times. The mirrors 7S and 79 areduplicates in construction and position of the mirrors (i3 and G-Ltpreviously described.

ln this modified form. the cabinet and accessories are substantially thesame as the previously described construction, with, however, thefollowing main exceptions` namely, the front panel S() is substantiallyvertical so as to allow room for the extension 7 (S and 'for the outerportion of the fluorescent screen and protectingr sheath. The cabinetfurther modified in that the portion which is recessed to receive thetoot consists simply ot an extended tapered housing composed of the topmember 81 and the side members S2. This housing;r is closed throughoutexcept for its outer rear end through which the toot of the patient isinserted. In this manner,

a free, unobstructed path is allowed for the fluorescent screen and tubeto rotate about this housing for the patients toot.

lf desired, plate holders maybe arranged upon the upper member 8l andupon the sides Si?. T hese plate holders are preferably removable, and,during a fluoroscopic examination ot the foot are preferably completelyremoved from the machine. As pointed out above, however, in place ofthese plate holders ay single plate holder may replace the fluorescentscreen or may be adapted t'or mountingr beneath such fhuirescent screen.The plate holders may be substantially similar to the screen holders,except that the plates are removably held. in the holders in any wellknown manner.

In all ot the forms of' the invention, the mirrors 63 and 64 or 7S and79, (depending upon which modification is considered),`- are providedwith cam shaped bottom portions. This is clearly illustrated in Finjures 2 and 9 tor the first modification.` and in Figure 7 for thesecond. Upon reterrinar to Figure 9 it will be seen that when the tubeis rocked to the left, for instance the cam member 69, it. will contactwith the then upper outer corner of the tube box. rlhis will raise themirror G3 from its normal. position, and will move it out of the way ofthe tube. At the same time the tube comes in line. with the screen uponthe opposite side oit the coinpartment for the toot and inline with themirror Gel. The path ot the X-ays is indicated at a-a, and it will beseen that such rays pass outwardly and thru any object that isinterposed between the tube and the screen finally impinging upon thescreen. The screen becomes luminous and emits visible rays. Thesevisible rays pass outwardly and strike the mirror (il from which theyare rellected upwardly along slanting lines until they arrive at the eyeot the observer. The path of the visible rays is indicated at bin Figure9. Also the-se rays are indicated by dotand dash lines in Figures l, 4,7 and 8. l

This form is particularly adapted for examining the foot at any desiredangle as the screen is always accurately positioned diaminetricallyopposite the tube. The adj listingn screws or other adjustingr means 83and 8l may be manipulated to cause the mirrors to assume the properangle to assur-e the reflection of the image to a point adjacent the eyecups.

It is of course understood that both the hood and bottom portion ot thecabinet may be suitably lined with lead, may be point-ed with a leadpoint,lor otherwise treated to prevent the outward passage of anyharmful rays.

It will thus be seen that an X-ray apparatus has been provided by whichthe examination of the patients` foot` may be readily and eficaciouslyconducted by unskilled operators. It Will also be seen that the machineor apparatus is practically fool-proof and may be placed in any store,for instance, Where'tlie men who operate the machine are not skilled inX-ray Work.

` It will also be seen that either the fluoro-l cabinet, a fluorescentscreen adapted tobe energizedby the rays from said tube, a series ofmirrors for reflecting the visible rays to the upper portion of saidcabinet, and a Series of members through which a patient and an operatormay look.

2. An X-ray apparatus comprising a cabinet, a panel upon which thepatient may place his foot and allow such foot to bear itsV share of theWeight ofthe body, an X- ray tube positioned WithinY said cabinet,

means for holding said'tube in any one of a plurality of positions aboutsaid foot, a

fluorescent screen adapted to cooperate with said tube, and a series ofmirrors for conducting the Visible rays tothe upper portion of saidcabinet whereby either the patient or the operator may iiuoroscopicallyeX- amine the foot. v

MATTHEW B. ADRIAN.

